From the Guidelines
Patients should wait at least 2 months after an acute episode of herpes zoster before receiving the shingles vaccine, as this minimal interval is recommended to minimize the risk of recurrence and ensure an optimal immune response to the vaccine. The decision to vaccinate after an episode of herpes zoster is supported by the high rates of recurrence, with a cumulative incidence of 2.5% at 2 years and up to 10.3% at 10 years after the initial diagnosis 1. The recommended waiting period varies between countries, but a minimal interval of 2 months is suggested based on the documented minimal time between an episode of HZ and recurrence of 2 months 1. Key considerations for vaccination timing include:
- The acute stage of HZ has resolved and symptoms have abated
- A minimal interval of 2 months between the episode of HZ and zoster vaccination
- The use of either zoster vaccine, ZVL or RZV, after a prior episode of HZ
- Consultation with a healthcare provider to determine the optimal timing based on the patient's specific clinical situation. Both available shingles vaccines can be used after an episode of HZ, but the preferred vaccine may vary based on factors such as efficacy and patient characteristics, with the recombinant zoster vaccine (RZV) being a preferred option due to its higher efficacy 1.
From the Research
Timing of Shingles Vaccine Administration
- The ideal time to administer the shingles vaccine after an acute episode of herpes zoster is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, it is recommended that individuals aged 60-years or older receive the vaccine, as the risk of herpes zoster increases with age 2.
- The studies focus on the efficacy and safety of the shingles vaccine in preventing herpes zoster and postherpetic neuralgia, rather than the timing of administration after an acute episode 3, 4, 6.
- One study discusses the presentation and treatment of herpes zoster, including antiviral treatment, but does not provide information on vaccine administration timing 5.
Vaccine Efficacy and Safety
- The live attenuated zoster vaccine (Zostavax) and the recombinant zoster vaccine (Shingrix) have been shown to be safe and efficacious in preventing herpes zoster and postherpetic neuralgia 2, 3, 6.
- The recombinant zoster vaccine (Shingrix) has been found to be more effective than the live attenuated zoster vaccine (Zostavax) in preventing herpes zoster 3.
- The vaccines have been approved for use in individuals aged 50-years or older, with the Centers for Disease Control and Prevention's Advisory Committee for Immunization Practices recommending the vaccine for individuals aged 60-years or older 2, 3.